The Best Cures for Addiction are Desire and Purpose

Posted on February 12, 2014

The Best Cures for Addiction are Desire and Purpose

Written for Practical Recovery by Stanton Peele, Ph.D., J.D.

Many neuroscientists claim that we have made great advances in addiction—that we have discovered its chemical sources in the brain and are on the verge of a cure. Recently, the Wall Street Journal published “A Pill to Cure Addiction?” (based on a JAMA Internal Medicine study). The article trumpets the cure for addiction by “transforming” the brain’s “chemical architecture.”

But that view of addiction reveals a basic misunderstanding of why—and how—people are able to overcome addictions. Worse, it makes it less likely that they will do so.

Contrary to the idea that withdrawal is the hardest part of quitting, people kick drugs and alcohol all the time. Most rehab patients abstain in treatment, only to relapse afterwards. The real task is not to quit, but to stay quit. This study, which measured the drinking of alcoholics treated with the drug gabapentin for only the twelve weeks of the study, doesn’t tell us that. Its results were that just 17 percent of alcoholics who received the highest dosage of the drug abstained in that time. A larger group, 28 percent, drank without bingeing.

Consider one study participant, Kathy Selman, described by the Journal. She didn’t actually know if she was on gabapentin, which means she may have experienced a placebo effect. She felt that she was taking the drug because she became depressed after completing the 12-week course of capsules. But becoming depressed after ceasing the medication would be a prompt for her to resume drinking. According to Ms. Selman, she relapsed in the past whenever she tried to quit but faced economic stress.

What was different this time? Ms. Selman says that she still faces a good deal of stress in launching her business ventures (one of which is now addiction coaching). But, she told the Journal, as a part of the research “she learned how stress triggered her desire to drink and ways to cope with the related wave of anxiety.” Her story points mainly to the benefits of cognitive-behavioral counseling, not the drug.

Let’s examine some of the major insights research on addiction has yielded over the years. In a study of Vietnam vets addicted to heroin in Asia, fewer than 10 percent remained addicted stateside—even though a third used a narcotic here. It isn’t really surprising to learn that soldiers addicted in a war zone ceased relying on the drug when they returned home. Unless, that is, you are one of the anointed addiction “experts” who claim that a person, once addicted, can never escape this fate.

The National Institute on Alcohol Abuse and Alcoholism (NIAAA), which funded the research reported in the WSJ, conducted its own research that confounds the JAMA study. Called NESARC (National Epidemiologic Survey on Alcohol and Related Conditions), the study interviewed more than 43,000 Americans about their lifetime drinking. The NIAAA reported: “Twenty years after onset of alcohol dependence, about three-fourths of individuals are in full recovery.” Moreover, the large majority of these were never treated for alcoholism nor joined AA! Also surprising to those anointed experts, as in the JAMA study, a majority of those who recovered in NESARC drank at “low-risk levels without symptoms of dependence.”

In another recent study, the Center for Global Tobacco Control at Harvard tracked smokers trying to quit who either did or did not use nicotine gum or patches. The investigators found that those who used nicotine replacements to quit didn’t do better than those who quit without it. In fact, the most dependent smokers were twice as likely to start smoking again if they used these aids than if they did not!

Those heavily dependent smokers who relied on the replacement drug were convinced they couldn’t succeed without it, and thus they relapsed when they stopped using the chemical boost. As Maia Szalavitz noted in a Time article entitled “Defining Obesity as a Disease May Do More Harm Than Good”: “labeling something a disease increased pessimism about recovery, probably because people assume that as diseases with biological and genetic bases, they are immutable.”

And, yet, the neurochemical thrust is infiltrating our society with the notion that all of our addictions (which now go far beyond drugs and alcohol) are diseases that only medicine can cure.

Despite this popular notion, most people quit smoking (along with alcoholism and drug addiction) on their own. They do so primarily due to their desire to quit. This desire is marked sometimes by previous failures—the CDC lists frequency of attempts to quit smoking as a primary predictor of ultimate success, since these efforts bespeak the intensity of the smoker’s motivation.

For Selman, this motivation included both her work and her fear that her “two sons would only know her as an alcoholic.” On top of this motivation the critical elements for her overcoming addiction are her beliefs that she is capable of quitting, and that she can live a fruitful life without it. She illustrates that recovery, whether through treatment or self-cure, requires faith in oneself and a life purpose.

Stanton Peele, Ph.D., has been a cutting-edge figure in addiction, from writing Love and Addiction in 1975, through his new book (with Ilse Thompson), Recover! Stop Thinking Like an Addict and Reclaim Your Life with The PERFECT Program.